~WELCOME~

Welcome to the July 2017 issue of the Washington Rural Health Association e-Newsletter. Inside this issue you will find news and information from the new Executive Director and board of directors, members, and community partners from across the state of Washington.

The WRHA e-newsletter is a publication of Washington Rural Health Association, a not-for-profit association composed of individual and organization members who share a common interest in rural health. This e-newsletter seeks to disseminate news and information of interest to rural health professionals and stakeholders to help establish a state and national network of rural health care advocates.

WRHA Members

WRHA members include administrators, educators, students, researchers, government agencies and workers, physicians, hospitals, clinics, migrant and community clinics, public health departments, insurers, professional associations and educational institutions. If you are interested in joining or renewing your membership with WRHA click here.

WCC AND UW Partner for Rural Health!

Bellingham, Wash. – Whatcom Community College has been selected by the University of Washington and the state Department of Health to advance leadership in health care education for western Washington.

As the new Area Health Education Center (AHEC), Whatcom works with regional partners to improve health care quality and access for rural and medically underserved communities. AHEC recruits students and health professionals from diverse backgrounds, and provides those health care professionals working in rural and underserved areas with accessible professional development.

“This significant opportunity to partner with one of the nation’s leading medical schools is an endorsement of our leadership in health care education,” Dr. Kathi Hiyane-Brown, president of Whatcom, said. “It also speaks to our success in working with local businesses and organizations to expand health programs, as well as meeting employer needs.”

Whatcom’s robust health education programs include nursing, physical therapist assistant, massage therapist and medical assisting. The College has added a new chemical dependency counselor program for mental health professionals, responding to community needs.

Initial projects for AHEC include the following:

Identify and promote health care training programs and initiatives that support underserved populations in western Washington;

Facilitate work groups with the goals of re-establishing a rural nursing distance learning program and increasing diversity in the nursing workforce in Washington State;

Recruit working professionals to serve as mentors to second-year medical students;

Develop the next generation of providers by promoting health care careers to high school students;

Collaborate with the Washington Work Group and training programs to recruit medical, dental and behavioral health students for clinical practice and residency positions in these rural locations.

Congress developed the AHEC program in 1971 to recruit, train and retain a health professions workforce committed to underserved populations.

About Whatcom: Whatcom Community College is a regionally and nationally accredited college with an accomplished faculty and staff who serve 11,000 students annually. On its campus in Bellingham, Wash., and through online courses, Whatcom offers transfer and professional-technical degrees as well as basic education, job skills training, and community education classes. The College is celebrating its 50th anniversary in 2017. For more information, visit whatcom.edu/50.

Getting to Know your Board Member!

Happy Summer! Washington Rural Health Association continues to reestablish itself as being the collective voice strengthening and advocating for the preservation and improvement of rural health in Washington state. To further engage you in the mission of the WRHA, we have added a new feature to our ENewsletter: a Board Member Profile. In each issue we will introduce you to one of our hard working board members to learn a little about who they are, their personal and professional interests, and why they became involved in WRHA.

Introducing.......SANDY BRECKER, WRHA Secretary

Q:Please tell me your name, where you work, title, your role with WRHA and how long you have been a board memberA:Sandy Brecker and I work for Premier, Inc. My title is Account Executive and I have been a board member for 2 years.

Q:How did you first become involved with the Washington Rural Health Association?A: I received a member email stating that there were upcoming open positions and instantly I was interested in the opportunity to serve so I put my name in for consideration.

Q:There are several rural health organizations in Washington State. Why did you choose to work with WRHA?A:Honestly WRHA and one other are the only two organizations that were really looking for support. The WRHA was actively engaged in trying to get members together through a conference, newsletter etc.

Q:Why is Rural Health important to you?A:From my perspective not being affiliated with a hospital, provider practice, etc. it is important to know what challenges the rural community faces and to try and offer solutions that will help those members. If we do not listen to the voices that are the most impacted then how do we improve the rural landscape? Bringing a voice to rural health and ultimately helping the betterment of lives in those communities is a great reason to want to be involved.

Q:What has surprised you most about working with Washington Rural Health Association?A:The learning curve about all of the areas WRHA touches. Getting to know what each committee is responsible for and the amount of work and passion each person on the board puts in to all of the committees.

Q:What is the best part of working with WRHA?A:Always learning something new and working with the other individuals on the board. Hearing perspectives on issues or challenges communities are facing.

Q:What do you see as some of the most challenging issues facing WRHA and Rural Health in our state?A:From my perspective many of the rural hospitals are struggling to keep their doors open, to employ good people that will want to stay in their communities and treat the people that come through their doors. Some larger health systems are competing in their communities as well. I also see and hear a lot of issues involving opioid abuse in these rural areas and it is heartbreaking. As for WRHA, the organization has made tremendous strides in the last few years by having a full time executive director on board and momentum and engagement from other members of the board. I think a hurdle is getting more members wanting to be engaged and getting those who are non-members to see the importance of this organization and to become engaged. The stronger we are the more we can affect change.

Q:What do you wish other people knew about Washington Rural Health Association?A:How much passion this group of volunteers are on the board and their commitment to making WRHA an organization other will want to be a part of.

Q:If you could change one thing about Washington Rural Health Association what would it be?A: The ability to do more for the rural population. The funds are limited. It would be great to be able to provide education and resources where the members need it.

Q:Do you volunteer for any other organizations? Why do you feel it is important to volunteer?A:I resided as the secretary for my HOA, and served on my city’s planning commission as vice chair and chair. I like the sense of community and working together. The culture of America has changed in which finger pointing and blame seem to be the norm instead of working together towards a common goal. We can have our differences and still in the end want the same things. I aspire to be a better person. As the quote goes “I want to be the person my dog thinks I am”.

Q:How do you like to spend your time outside of work and volunteering?A: Being with my husband and two dogs. I enjoy traveling and am very adventurous. I try living my life without regret about the things I should have seen or done by doing them in the first place.

Q:What might (someone) be surprised to know about you?A:Ah…I always loved to dance so I convinced a friend years ago to go to a belly dance class with me. We ended up performing in a show every year and for our duets and my solos I did all of the choreography. Not sure that is what the members would want to hear though. It is a beautiful expression of moves, but to some who don’t really know what it is about tend to have a negative view on it. I studied karate for several years. It was the Korean art of “Tang Soo Do” but it incorporated techniques from Japanese, Chinese, Okinawan, Western, Muay Thai and Boxing styles. I have been married for 38 years. Met my sweetheart in high school when I was 16 and right after high school we got married because we loved each other, not because we had to. Been together ever since!

Q:What do you think will change about Washington Rural Health Association over the next five years?A: I wish I had a crystal ball. Legislation over everything. It makes it hard to get work done. It seems in general that there are just going to be more restrictions on everything and that comes at a price.

The TRUST Experience

“I’ve never really thought of myself as an advocate or wanting to get involved within the politics of systems.” Elizabeth Reed UW TRUST Scholar

Creating the workforce needed for rural Washington is a goal the University of Washington School of Medicine considers part of its mission. The methods used to attain this goal are multi-faceted out of necessity. Practicing in a rural environment is absolutely enriching for some medical students and burdened with trepidation for others. The expectation to be engaged outside of the exam room and in our communities is one of these challenges. To meet this need, the University of Washington’s Targeted Rural Underserved Track (TRUST) teaches leadership skills to its students during an annual four day retreat.

Physicians are expected to be leaders in their communities and within their health systems. This is especially true in rural communities where the expectation of leadership is a reality. Leadership education should begin at the medical school level tobuild a foundation for future practice. However, only 35% of medical schools require a leadership curriculum and the licensing board for medical schools does not have requirements for leadership training. Expectations of physician leaders include communication skills, ethics training, conflict resolution, population health research, and coordination of health resources. Studies show that residents who feel prepared to be a community leader are more likely to practice rurally. At the same time, only 40% of residency graduates feel prepared to take on leadership roles. This disconnect is an issue for our future physicians.

“I learned many new skills during the retreat - and I loved being taught by my colleagues. After leaving I felt empowered to take on more leadership. Leadership is incredibly important for rural doctors because we are in a key position in the community to affect change.” Kelsey Kent UW TRUST Scholar.

The University of Washington’s Targeted Rural Underserved Student Track (TRUST) seeks to connect medical students to rural communities in an effort to meet workforce needs. It provides a continuous connection between underserved communities, medical education, and health professionals in our region. TRUST creates a full-circle pipeline by guiding qualified students through a special curriculum that connects underserved communities in Washington, Wyoming, Alaska, Montana and Idaho (WWAMI states) to the University of Washington School of Medicine (UWSOM) and its network of affiliated residency programs. Beginning the summer before medical school and continuing throughout the curriculum, TRUST scholars participate in clinical and classroom experiences, on-line discussions, and regional or national conferences, exposing them to the satisfaction, challenges, and life style of a physician practicing in rural and underserved areas.

The leadership retreat brings together TRUST students from Washington, Wyoming, Alaska, Montana and Idaho (WWAMI) in a remote setting on Flathead Lake in Montana.

“I loved getting to "escape" from the big city of Seattle to connect with my fellow TRUST classmates who are passionate about rural health care. I felt so supported being around others who have the same interests, to learn from one another and share stories of our experiences in rural settings.” Elizabeth Polsin UW Trust Scholar

Our rural communities need leadership. Rural physicians are uniquely suited to play a role in community leadership teams to support health services and other local needs related to population health and community wellness. Teaching leadership skills and the importance of this role to medical students bound for rural towns is critical to fostering success and interest in rural practice.

“This leadership retreat was great for helping me to develop not only my leadership skills, but get excited about being an advocate for my patients especially in these often, overlooked rural communities. Meeting my fellow TRUST classmates, I came away feeling inspired about our future practices as physicians.” Elizabeth Reed UW TRUST Scholar

Mental Stimulation and Exercise for Seniors

It’s no secret that growing older comes with a few challenges. Fortunately some health related issues can be reduced or prevented, if the necessary precautions are taken. Dementia and cognitive decline are becoming major concerns in senior wellbeing; however, partaking in mentally stimulating exercises can help minimize the chances of developing dementia or alzheimers tremendously. Here are a few ways seniors can exercise and challenge their brain!

Word games and puzzles!

With the number of people diagnosed with dementia being 47 million worldwide and climbing at an alarming 7.7 million people yearly, now is the best time to be proactive in increasing mental health. As adults get older, their chances for developing conditions like dementia and alzheimer's drastically increase. Playing word games is a great way for seniors to reduce the risk and keep their mind challenged. Many people view games as a great way to pass time, however there is much more to gain --especially for older adults! Word games help improve vocabulary and cognitive functioning. These games also help sharpen their mind by giving them the ability to learn new things. Scrabble is a fun word game that increases hand-eye coordination in adults, which boosts brain exercise and functioning. Because Scrabble is a board game, it can be enjoyed by up to 4 people and it presents a great way for seniors to be social! Great for playing with family or friends who are residing at an assisted living facility, this word game will help older adults improve their spelling and reduce stress all while being around friends or family!

Games that are played alone are also beneficial to the mental health of older adults. One of the most popular brain training games for seniors is Sudoku. This game allows individuals to differentiate patterns through the use of problem solving and logistical processes. With age, the brain tends to become burnt out or stagnant because adults have become accustomed to solving the same types of problems over and over again. Fortunately with Sudoku, the brain uses synapses that allow seniors to fill in gaps and learn how to solve different types of problems. It is important to remember that learning can be done at any age and most word games are easy-to-understand so that practically anyone can pick up the habit. Crossword puzzles and other word games do not have to be finished in one sitting, and setting aside some time to work through a few clues daily can help older adults jog their memory and keep their brain balanced.

Get physical outdoors!

It has been proven that those who keep their minds and bodies active are less likely to develop dementia. In fact, those seniors that play mind games and are physically active regularly reduce their risk of developing dementia by 63 percent. Physical activity does not have to be strenuous, and something as simple as seniors walking their dog daily will be beneficial. Those without dogs of their own might offer to walk a busy family member’s dog or take on some dog walking clients. The great thing about spending time with dogs is that they offer mental health benefits in addition to helping us improve our physical health.

Growing older is a privilege that is meant to be cherished and enjoyed. The best way for older adults to enjoy transitioning into the golden years is to be of sound mind and body. Developing the habit of playing word games and exercising regularly will ensure that this stage in their life will be of good health and well-being!

New Pediatrician at Shriners - Spokane

Shriners Hospitals for Children - Spokane is pleased to announce a new member of our medical care team. Ryan Baker, M.D. joins us as our second full time pediatrician. Dr. Baker will treat children at the Spokane Shriners Hospital as both a pediatrician and running a pediatric sports medicine clinic. "It is great to be a part of this team!" said Dr. Baker. "The way we treat the patient here, and truly provide comprehensive kid directed care is special; it's exactly what I was looking for in my practice. Kids are awesome, and they are definitely treated like it here." In his off time, Dr. Baker enjoys being at the beach or in the mountains with his wife and two children. An alum of both Whitworth University and the University of Cincinnati, Dr. Baker is "unfortunately or fortunately a Cincinnati Bengals fan now, as well as being an L.A. Dodgers fan." However, Dr. Baker admits to rooting for the Zags most. The Spokane Shriners Hospital is extremely excited to have Dr. Baker as part of our expert pediatric orthopaedic team. We know his real loyalty lies, just like the rest of us, with the kids that we treat.

Submitted by: Betsy Lieberman and Esther Lucero Co-Chairs for the King County Accountable Community of Health

King County Accountable Community of Health Welcomes First Executive Director!

On behalf of the King County Accountable Community of Health Governing Board, we are excited to welcome Susan McLaughlin, PhD as its new Executive Director. Susan will provide leadership for the King County Accountable Community of Health (ACH) including overall strategy, operations and collaboration across multiple partners working for better health in the King County region. A central focus is bringing together partners to implement the Medicaid Transformation Project Demonstration in our county. This is a strategic opportunity to attract significant federal investment to our region to improve health outcomes and address the social and economic factors that impact health.

The King County ACH Governing Board set out to find someone with the right vision and a deep understanding of health, health equity, health care delivery and financing. We are delighted to announce that we've found that leader.

In Susan's own words: "I am honored to be selected as the Executive Director for the King County ACH. I truly believe that together we can transform how we do business and create a health care system that focuses on prevention, embraces recovery, and eliminates disparities. I look forward to working with the Governing Board and all of our community partners to achieve this goal."

Susan is coming to the King County ACH from the King County Department of Community and Human Services as the Health and Human Services Administrator. In that role, she led the County in its efforts to move to fully integrated physical and behavioral health and led programs and policies to assist the county's most vulnerable residents and strengthen its communities. She has been a pioneer in advocating for family and youth involvement, including authoring a family inclusion model to ensure family and youth voice in systems and program development. Susan received her PhD in Clinical Psychology from the University of California San Diego/San Diego State University Joint Doctoral Program. "We are proud to support this effort to ensure that residents have access to quality health care, which benefits our entire region.

This project is a tremendous opportunity to transform Medicaid services in King County to improve health outcomes and well-being," said Tony Mestres, President and CEO of Seattle Foundation, which is the sponsoring organization for the ACH. "It's wonderful to have someone with Susan McLaughlin's experience and credentials to innovate our regional health services to better meet needs in the community."

Submitted by: Douglas Borg, Premier Insurance Management Services (PIMS) – a subsidiary of Premier, Inc.The Health and Human Services (HHS) department recently announced that their new cybersecurity center will come on-line June 30, 2017. Based on Homeland Security’s National Cybersecurity and Communications Integration Center, the new service will share healthcare-specific threats information with other agencies as well as the private sector.

The recent WannaCry ransomware attacks are a sharp reminder of how disruptive and devastating IT attacks can be. Over the last few weeks, hundreds of thousands of computers and networks across the globe were affected, with systems being locked down by the malicious software that demanded payment before releasing the users’ files.

Leo Scanlon, HHS senior advisor for healthcare public health cybersecurity, recently discussed the challenges facing healthcare organizations, and the current lack of resources necessary to manage the constant barrage of threats to organizations, data and equipment. “How many mortuaries do you think have a cybersecurity officer protecting their systems?” Scanlon asked. “Guess what's in a funeral home? The entire life history of every single person whose body is passing through medical records—cause of death, time of death, place of death. Everything you need to create an identity.”

Only about 2 percent of the sector—the insurance and pharmaceutical companies—have the resources and the know how to protect their data and share information with each other. “Below the 2 percent is 98 percent of the rest of the sector that has virtually no cybersecurity capability, often not even a CIO in a small- or medium-size medical practice,” Scanlon said. The Center has been operating in “beta” mode while the collaborative relationships with other federal agencies, such as CMS and the FDA, have been established. They will also focus on building partnerships with other healthcare agencies, sharing best practices and information about threats.

About Premier Insurance Management Services Inc. (PIMS)

PIMS is an Illinois for-profit corporation and subsidiary of Premier Inc., providing contracted management services for AEIX, and its attorney-in-fact. PIMS also serves as program manager offering enhanced endorsed programs with leading commercial insurers through a comprehensive portfolio of property, casualty, and employee benefit products. Other services include providing claims and risk management assessments and education offerings regarding medical professional liability for hospitals and their physicians. For more information, visit https://www.premierinc.com/insurance.

Practice Transformation

Primary care practices are at the core of our health system and are well positioned to provide whole-person care. However, to achieve the “Triple Aim” of better care, better health and lower costs, changes need to be made in the way health care is delivered and reimbursed. For some practices, this transformation may require a few important changes. But for others, it may mean a significant re-visioning of the way care is delivered.

There are many resources in Washington State to support practices in these efforts. But to a busy practice already short on time and resources, the offers of help can seem overwhelming.

Provider Centered Support for Patient Centered Care

To make this task easier, the Healthier Washington Practice Transformation Support Hub and Qualis Health have created a Practice Transformation Directory of available help. Here providers can find information on a range of practice transformation opportunities available in Washington State and how to connect to the ones most relevant to their practice goals. All programs listed here are free, and share the common goal of helping practices achieve sustainable improvements and patient outcomes as they move towards value-based care and integrated primary care and behavioral health.

A downloadable PDF version of the Directory can be found on the Hub Resource Portal here. The Portal is an interactive website that houses a library of carefully selected practice transformation tools and resources. It is developed, curated and maintained by the University of Washington’s Department of Family Medicine Primary Care Innovation Lab (PCI-Lab) and can be accessed here.

For more information on the directory, how to find practice transformation support, or Practice Transformation Support Hub, contact the Hub Help Desk at (206) 288-2540 or (800) 949-7536 ext. 2540 or email: HubHelpDesk@qualishealth.org.

Keeping You in the Know

State Agencies Provide Notice to Contractors Regarding Possible Budget Delay Recently the Health Care Authority, the Department of Health, and other state agencies sent notices some entities contracted with the state. The notice says state contracts will be suspended if the legislature fails to agree on budget appropriations for the upcoming biennium by midnight of June 30, 2017. HCA did not suspend Core Provider Agreements for Medicaid providers. However, there will likely be a payment delay to those providers as HCA will stop all administrative activity. The notice advises that if the budget is not enacted by midnight of June 30, contractors should suspend delivery of goods or the performance of services until the budget has been enacted.

Because many health care services cannot be delayed due to EMTALA requirements or patient care concerns, it is likely the operating budget, when enacted, will cover medical services retroactive to July 1. If the budget is enacted significantly later than June 30, there may be a delay in claim payments directly from the state and through managed care plans for Medicaid and PEBB until the funding is authorized. Hospitals and health care providers should prepare for the possibility of cash flow issues related to delayed payment.

HCA Finalizes Rules on New Rural Health Clinic Payment, Coverage for Incarcerated Patients The Health Care Authority adopted final rules on two items WRHA has been involved in.

Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) – Payment Methodologies and General Payment Information (WSR 17-12-016). HCA modified the rules to accommodate the new value-based alternative payment model for FQHCs and RHCs electing to participate in a new value-based model. Currently, eleven FQHCs and one RHC have indicated they are interested in participating.

Suspending Medical Assistance During Incarceration,(WSR 17-12-017). In response to new legislation, HCA is suspending rather than terminating medical assistance benefits for people who are incarcerated in a jail or prison. The purpose is to facilitate continuity of health care coverage and services for prisoners upon discharge from a corrections facility.

Report cites ways communities can transform rural health care for WashingtoniansAs a group, rural communities tend to be older and sicker than residents in urban areas. At the same time, they have less access to health care, which means their conditions are often diagnosed later with more serious findings.

The Healthier Washington Rural Health Innovation Accelerator Committee has produced a report that identifies “A New Vision for Rural Health in Washington State,” based on an assessment of the rural health landscape and a series of convenings that included entrepreneurs and thought leaders from the public and private sectors.

“To address this problem, access to quality health care must be increased and sustained in rural areas of our state. This includes health risk assessments, prevention and wellness programs,” the report says. The committee, a subgroup of the initiative’s Health Innovation Leadership Network, puts forth seven areas of opportunity to transform the way rural Washingtonians receive health care.

The committee is optimistic that Washington State’s leadership in technology and health care innovation will present momentum and resources to lead the nation in resolving the inequities in rural health.

“Our committee believes the breakthroughs for Washington may not come from the institutional players of health care (payers, providers and government institutions) but in part from Washington’s unique environment of backyard companies.”

The Practice Transformation Support Hub is pleased to partner with the University of Washington AIMS Center to present a one-hour webinar on financing integration of primary care and behavioral health.

This third Hub learning event for 2017 features Anna Ratzliff, MD, PhD, Associate Director for Education at the UW AIMS (Advancing Integrated Mental Health Solutions) Center and Director of the UW Integrated Care Training Program. Dr. Ratzliff will discuss financing and sustainability strategies for behavioral health integration in Washington state, and provide a brief introduction to a new financial modeling tool.

According to a CDC study, health care challenges including lack of preventive care, socioeconomic factors, and the shortage of primary care clinicians are affecting rural areas disproportionately. “We’ve spent so much time thinking about health care, but research has shown the majority of health is driven not by what happens in the doctor’s office, but by what happens in the rest of our lives,” says NRHA member Carrie Henning-Smith, PhD, with the University of Minnesota Rural Health Research Center. NRHA Clinical Services Constituency Group chair Roger D. Wells also points out that telemedicine can only do so much when many rural Americans still lack internet access.

Last but not Least, More Items of Interest....

DEADLINE EXTENDED TO COMPLETE MEMBER SATISFACTION SURVEY

We want to hear from you. WRHA needs your help! This membership survey will examine ways in which our association can better meet your needs. We are working to bring additional value, we cannot make a lasting impact without your involvement. We greatly appreciate your feedback! Please click on the link below and complete the survey by: Friday, July 14.

We are excited to announce NEW advertisement opportunities in our bi- monthly digital newsletter. Have your name in front of more than 150 health care leaders from Washington’s rural health care sector who can go directly to your website by clicking on your logo.

Washington Rural Health Association is a 501(c)3 non-profit, grassroots organization. In efforts to reestablish a presence on the internet, we’ve changed the WRHA domain name from www.wrha.com to www.waruralhealth.org. To ensure you receive future emails, please add www.waruralhealth.org to your address book or safe sender list.

2018 NW Rural Health Conference Planning Update: Dawn Bross of the Rural Health Clinic Association of Washington, has been named conference manager. Krista Loney from WWAMI - Area Health Education Center and Beionka Moore will serve as the 2018 conference leadership team. This conference, also organized with the assistance of the State Office of Rural Health, Washington State Department of Health (SORH/DOH), includes representation from many agencies and organizations in the Pacific Northwest. This popular & informative event will take place at The Davenport Grand, 333 West Spokane Falls Blvd, Spokane - March 26-28, 2018. Stay tuned for more exciting news to come!

LEGISLATIVE SESSION UPDATE

If you don’t like what is going on with health care, you need to become involved with WRHA and other organizations that support nonpartisan, grassroots efforts to make sure that the rural voice is heard. There has never been a more important time for health care and rural health care. In the early 1970’s, health advocates pushed for healthcare as a “right” not a “privilege”. Fifty years later, we are seeing what is perhaps the biggest reduction in access to health care since the 70’s.

The legislature released a $43 billion operating budget for the 2017-2019 biennium. We’ve avoided a partial state government shutdown by mere hours. WRHA has had a very active legislative session. We are very pleased with the results for health care overall, and particularly for rural facilities. We extend our gratitude and applauds the legislature's for additional funding of important reforms to the state's mental health system.

The main issue at play this session has been how the legislature would meet the Supreme Court's McCleary mandate to fully fund basic education. The Democratic House and Republican Senate started billions of dollars apart on this and other spending issues, but eventually closed the gap using increased revenue projections from existing sources, a complicated property tax mechanism and limited new sources of revenue. Finally, it appears that action on the capital budget will be delayed until at least mid-July pending compromise on a solution to recent water rights litigation.

Items of note for hospitals and health systems:

No cuts to Medicaid payments for hospital-based clinics

Hospital safety net assessment funded

Significant progress on mental health care funding and reforms

No increase to the business and occupation (B&O) tax

Rural hospitals received funding for the Washington Rural Health Access Preservation (WRHAP) program and nursing home payments

Medicaid waiver funds appropriated

Plans to integrate the financing for mental and physical health still on track

Your support allows us to do more to Advocate, Collaborate and Educate!TOGETHER OUR VOICES ARE LOUDER AND STRONGER!

Join the discussion, connect with us! Share your stories and ideas, get the latest news, and act to help preserve rural health care and access in Washington state! Please head over to Facebook, Twitter or LinkedIn and look us up at WASHINGTONRURALHEALTH!